KPEERI Only Application | The Center for Effective Reading Instruction

Applicant Profile Information

Name*

First Middle Last Suffix

Address Type

International Address?

Business Address For Online Listing - USA*

Street Address Address Line 2 City State ZIP Code

Business Address For Online Listing - International*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Enter Email Confirm Email

Primary Phone*

Highest Degree Held*

Major*

Upload degree or transcript*

In order to take the KPEERI exam you must hold a Bachelor’s degree or higher. Your degree can be in a field other than education. Documentation must include the name of the issuing institution as well as the year the degree was awarded. Professional licenses are not acceptable.
Please upload a copy of your degree or transcript showing the completion of your degree. (Section max file upload size 5MB.)

Drop files here or

Accepted file types: pdf, jpeg, jpg, png, gif, doc, Max. file size: 5 MB, Max. files: 2.

Name of IDA Pipeline Program*

Please select the name of the IDA Pipeline program in which you are currently participating. If your program does not appear in the list, please select None.

Demographic Information

Are you Currently Teaching at a Public or Private School?*

Public
Private

What Grade(s) do you Teach?*

Is your School in an Urban, Priority, or Rural district?*

Yes
No

How Many Students do you Impact in One Academic Year With Structured Literacy in the Classroom?*

Why are you applying for the KPEERI Exam? (optional)

Additional Information / Comments (optional)

Please include any additional information related to this application.

Applicant Affirmation

IDA Branch*

By selecting 'I agree', I give permission for CERI to share my contact information with my local IDA branch.

I agree.

Affirmation*

1) I affirm that all of the information provided on this application is true, accurate and fully responsive to the questions asked.
2) I have read and agree to abide by the code of ethics of the Center For Effective Reading Instruction that are found within the Knowledge and Practice Standards for Teachers of Reading (KPS).
3) I understand that, once certified, my certification status may be made available to the public.

I agree

Payment

Legal Name*

The name submitted for the KPEERI exam must exactly match your legal name as it appears on your government issued photo identification. Please enter your name exactly as it appears on your driver's license, passport or other government issued ID.

First (Given) Name Last (Family) Name

Institute or Program Paying for KPEERI Exam

Please select 'Yes' if your program or institution has offered to pay the exam fees associated with your application. Please note that institutional payment is subject to verification before an application can be processed.

No
Yes

Approved Programs for KPEERI Prepayment*

Documentation of Institutional Payment*

If your program or institution has provided you with a voucher or other documentation of their willingness to pay your exam fees please upload it here. (Section max file upload size 5MB.)

Drop files here or

Accepted file types: pdf, jpeg, jpg, png, gif, doc, Max. file size: 5 MB, Max. files: 2.

KPEERI Exam*

Price:

KPEERI Processing Fee*

Price:

(non-refundable)

Total

$0.00

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Discount Code

CAPTCHA

Comments

This field is for validation purposes and should be left unchanged.